# Great American Assurance Company

**Administrative Offices**
301 E 4th Street
Cincinnati OH 45202-4201
513 369 5000 ph

**POLICYHOLDER NOTIFICATION - NEW YORK**

**NOTICE - THESE POLICY FORMS AND THE APPLICABLE RATES ARE EXEMPT FROM THE FILING REQUIREMENTS OF THE NEW YORK INSURANCE LAW AND REGULATIONS. HOWEVER, THE FORMS AND RATES MUST MEET THE MINIMUM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS.**

Classification Code: 91585

SDM-841 (Ed. 07/14)
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